March 01, 2024 Making lasting changes in the community to help prevent diabetes

Who:

Dr. Mary Jung, associate professor in the School of Health and Exercise Sciences, University of British Columbia

Research highlights/discoveries:

• Helping implement a diabetes prevention program and studying its impact in rural communities and urban centres.

Dr. Mary Jung at a glance:

• Named a member of Diabetes Canada’s National Research Council, a group of experts who advise the organization and make scientific recommendations (2022)

• Awarded the Canadian Institutes of Health Research (CIHR) Healthy Cities Implementation Sciences Grant, and given additional funding from the Public Health Agency of Canada (PHAC) and the Australian National Health and Medical Research Council (2023)

• Named UBC Killam Accelerator Research Fellow (2023)

• Received End Diabetes: 100 Award from Diabetes Canada (2021–2024)

• Granted the CIHR Early Career Investigator Foundation Award (2015–2021)

• Received the Michael Smith Foundation for Health Research Scholar award (2014–2019)

Tell us about the Small Steps for Big Changes program you’re involved with.

This is a free diabetes prevention program that started as a pilot in our lab in 2012. After demonstrating its effectiveness, we launched the program into the community of Kelowna, B.C., in 2017. It was created to help empower people to make lasting dietary and exercise changes to lower their risk of developing type 2 diabetes using evidence-based counselling techniques.

We know that in B.C., remote and rural areas are underserviced in terms of healthcare providers and community-based diabetes prevention programs, so it’s exciting to implement something that will be accessible to people who need it. With support from Diabetes Canada, my team and I are expanding this program into northern communities in B.C. over the next three years.

How will this work?

After a year of staff training, adaptation meetings and community site visits, we have started implementing Small Steps for Big Changes in Prince George and Vanderhoof, B.C. In these communities, people who have been diagnosed with prediabetes have very little access to diabetes educators.

This program is all about taking small steps that will lead to big changes. Each person who signs up or is referred to the program receives six one-on-one counselling sessions with a trained coach, and a complimentary one-month membership to their local fitness facility. Their coach continues to meet with them for several follow-up appointments, where they discuss progress toward diet and exercise behaviours and blood sugar management.

What is the impact of the program so far?

At first when we set up in a community, people are excited and eager to get involved. Then, after being part of the program, they ask how long it will be offered because they want their partners, family members and friends to join—so we know it is filling a void and is being well received. Our goal is to make Small Steps for Big Changes sustainable for the long term in all communities that need it.

How will you do that?

We are involving community members to launch the program. We work with them to adapt it to best suit their community, being sensitive to aspects such as food sources, safe and accessible places to exercise, and the availability of healthcare providers. Working together, we develop a recruitment and referral pathway by connecting with local physicians, pharmacists and any other healthcare providers or community health champions who want to get involved. The local community members we hire go through intensive training and receive full support from us throughout the program delivery period, to ensure they have all the skills and resources required to be successful in implementing Small Steps for Big Changes.

We’ve developed a really good blueprint on how to deploy this program in different rural communities, including creating resources on standard operating procedures and virtual site and staff training. We’ve also received further funding to expand into urban centres across Canada and Australia. We are working with 44 YMCAs in Canada and five in Australia over the next five years to implement the program in urban cities. There is a need for evidence-based diabetes prevention programs in both rural and urban settings, and we are proud to be able to offer a sustainable solution to fill this void.

What’s your ultimate goal?